Background : The hepatopulmonary syndrome (HPS) is defined as the triad of liver disease, arterial deoxygenation, and pulmonary vascular dilatation. The reported prevalence of HPS in cirrhotic patients varies between 5% -17.5%.Objective : To estimate the prevalence of hepatopulmonary syndrome among patients with chronic liver disease and portal hypertension and to study the correlation between HPS and the severity of liver disease.Patients and methods : Thirty patients were studied for the presence of HPS using transthoracic contrast echocardiography for detection of pulmonary vasodilatation. Arterial oxygen saturation (SaO2) was determined in erect and supine position using a pulse oximeter , (SaO2 ≤ 92 % in supine position and/or a decrease of ≥ 4% after change from supine to upright position) to detect hypoxia and ortheodeoxia.Result : Eleven of thirty patients (36.6%) with chronic liver disease and portal hypertension were found to have contrast echocardiographic evidence of intrapulmonary right-to-left shunting. Arterial oxygen desaturation was present in 3 patients (27.3%) of those with intra-pulmonary right-to-left shunting ,they were considered as clinically significant HPS ,the remaining 8 patients were considered as subclinical HPS. Dyspnoea was more often present in patients with clinically significant HPS (100%) compared with subclinical HPS (25%), and patients without HPS (9%). HPS correlated significantly with severity of liver disease according to the Child-Pugh score.Conclusion: hepatopulmonary syndrome is not uncommon , the prevalence of clinically significant hepatopulmonary syndrome (in this study) was 10% of patients with chronic liver disease and it correlated with disease severity according to the Child-Pugh score
Sumatriptan(ST) is a selective agonist at serotonin 5-HTI receptors, as well as 5-HT1B/1D subtypes. It is effective for acute migraine attacks, but has a short half life (about 2 hours) and low oral bioavailability (15%). The purpose of this study was to develop and optimize nasal mucoadhesive in-situ gel(IG) of ST to enhance nasal residence time for migraine management. Cold method was used to prepare different formulas of ST nasal IG, using thermosensitive polymers (poloxamer 407 alone or with poloxamer 188) with a mucoadhesive polymer hyaluronic acid (HA) which were examined for gelation temperature and gelation time, pH, drug content, gel strength, spreadability, muc
... Show MoreRegulatory T (Treg) cells are one of the major immunosuppressive cell types in cancer and a potential target for immunotherapy, but targeting tumor-infiltrating (TI) Treg cells has been challenging. Here, using single-cell RNA sequencing of immune cells from renal clear cell carcinoma (ccRCC) patients, we identify two distinct transcriptional fates for TI Treg cells, Fate-1 and Fate-2. The Fate-1 signature is associated with a poorer prognosis in ccRCC and several other solid cancers. CD177, a cell surface protein normally expressed on neutrophil, is specifically expressed on Fate-1 TI Treg cells in several solid cancer types, but not on other TI or peripheral Treg cells. Mechanistically, blocking CD
Highly Modified Asphalt (HiMA) binders have garnered significant attention due to their superior resistance to rutting, fatigue cracking, and thermal distress under heavy traffic loads and extreme environmental conditions. While elastomeric polymers such as Styrene- Butadiene-Styrene (SBS) have been extensively used in HiMA applications, the potential of plastomeric polymers, including Polyethylene (PE) and Ethylene Vinyl Acetate (EVA), remains largely unexplored. This study aims to evaluate the performance of reference binder (RB) modified with plastomeric HiMA asphalt in comparison to SBS-modified binders and determine the optimal polymer dosage for achieving an optimal balance between rutting resistance and fatigue durability. The experi
... Show MoreCerium oxide (CeO2), or ceria, has gained increasing interest owing to its excellent catalytic applications. Under the framework of density functional theory (DFT), this contribution demonstrates the eect that introducing the element nickel (Ni) into the ceria lattice has on its electronic, structural, and optical characteristics. Electronic density of states (DOSs) analysis shows that Ni integration leads to a shrinkage of Ce 4f states and improvement of Ni 3d states in the bottom of the conduction band. Furthermore, the calculated optical absorption spectra of an Ni-doped CeO2 system shifts towards longer visible light and infrared regions. Results indicate that Ni-doping a CeO2 system would result in a decrease of the band gap. Finally,
... Show MoreBackground: Semen contamination is a detrimental factor in decreasing fertility. Seasonal changes may affect the contamination, too. Objectives: This study was designed to detect semen contamination in ovine and caprine during different seasons. Methods: Six fully mature male sheep and goats were subjected to electro-ejaculator collection twice monthly from February 1, 2022, to January 31, 2023 (Spring, February 1, 2022-April 30, 2022; Summer, May 1, 2022, July 31, 2022; Autumn August 1, 2022, October 31, 2022; Winter November 1, 2022, January 31, 2023), for studying the seasonal effect. A total of 288 semen samples were collected from both species (36 samples from each per season). All samples were subjected to bacterial isolatio
... Show MoreThis paper proposes a new structure of the hybrid neural controller based on the identification model for nonlinear systems. The goal of this work is to employ the structure of the Modified Elman Neural Network (MENN) model into the NARMA-L2 structure instead of Multi-Layer Perceptron (MLP) model in order to construct a new hybrid neural structure that can be used as an identifier model and a nonlinear controller for the SISO linear or nonlinear systems. Weight parameters of the hybrid neural structure with its serial-parallel configuration are adapted by using the Back propagation learning algorithm. The ability of the proposed hybrid neural structure for nonlinear system has achieved a fast learning with minimum number
... Show MoreIncremental sheet forming (ISF) is a metal forming technology in which small incremental deformations determine the final shape. The sheet is deformed by a hemispherical tool that follows the required shape contour to deform the sheet into the desired geometry. In this study, single point incremental sheet forming (SPIF) has been implemented in dentistry to manufacture a denture plate using two types of stainless steel, 304 and 316L, with an initial thickness of 0.5mm and 0.8mm, respectively. Stainless steel was selected due to its biocompatibility and reasonable cost. A three-dimensional (3D) analysis procedure was conducted to evaluate the manufactured part's geometrical accuracy and thickness distribution. The obtained results confirm
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